a 73-year-old man with long-term immobility presenting with abdominal pain一个73岁的老人与长期不动出现腹痛.pdf

Learning Forum A 73-Year-Old Man with Long-Term Immobility Presenting with Abdominal Pain 1 1 2 1 3 Salomone Di Saverio *, Gregorio Tugnoli , Paolo Emilio Orlandi , Marco Casali , Fausto Catena , Andrea 1 4 1 Biscardi , Omeshnie Pillay , Franco Baldoni 1 Departments of Emergency and Surgery, Emergency Surgery and Trauma Surgery Unit, Trauma Center, Maggiore Hospital–Bologna Local Health District, Bologna, Italy, 2 Department of Radiology, Maggiore Hospital–Bologna Local Health District, Bologna, Italy, 3 Department of Emergency and Transplant Surgery, S. Orsola Malpighi University Hospital, Bologna, Italy, 4 Addington Hospital, Durban, KwaZulu-Natal, South Africa In summer 2008, a 73-year-old man Box 1. Intestinal Obstruction: Diagnostic Workup arrived in the emergency room with vague abdominal pain. On examination, his N Supine and erect plain abdominal X-ray abdomen was distended and tympanic, but soft and non-tender on palpation. The N Abdominal ultrasound (this is of limited value in bowel obstruction and/or in patient had been immobile and bed- patients with distended bowel because the air, limiting ultrasound transmis- ridden since 1995, when he had neuro- sion, may obscure and camouflage the underlying findings) surgical resection of a medullary ependy- N CT scan moma of the spine, with residual paraple- N Conventional barium follow-through examination, upper gastrointestinal and gia, peripheral neuropathy, and a small bowel